Couple’s Questionnaire

These series of questions will give you and your partner insight into your relationship. By completing the questionnaire, you will be reminded of what brought you together and better understand what may be driving you apart. Copy and paste the questions into a word document or print out the PDF and bring your answers with you to your first session. By answering these questions and sharing them with your therapist, you will save time and money and get off to a powerful start on the path to a better relationship.

1. What is the problem that led you to decide to come to therapy?
2. How long have you and your partner been together? In what form: dating, living together, married?
3. What initially attracted you to your partner and how did you decide to be partners?
4. What do you find most fulfilling about your relationship?
5. What was the very beginning of your relationship like? How long did this phase last?
6. What was your first disillusionment? What happened and how did you resolve it?
7. When do you feel least fulfilled in your relationship?
8. In what significant ways are the two of you similar? Different?
9. How do you resolve conflicts? What do you do when you are angry? What does your partner do when angry?
10. Do you spend time in activities away from your partner? If so, how often? Do you spend time alone with people who are not mutual friends? Does this create conflict in your relationship?
11. How comfortable are you doing activities away from your partner? How comfortable are you with your partner doing things away from you?
12. How safe do you feel expressing your innermost thoughts and feelings to your partner? How do you ask for emotional support from your partner when you are feeling vulnerable? Do you expect to get it?
13. Would your partner say that you are emotionally responsive to his/her vulnerability? Explain.
14. Do you take an active, energetic role in nourishing the relationship? Does your partner do the same? How?
15. Do you support your partner’s development as an individual? How (give example)? Do you support his/her growth as an individual even when you don’t agree? How (give example)?
16. Do you believe that your partner is giving at least 50% to the relationship?
17. Do the two of you have joint commitments to projects, work activities or social causes? If so, what?
18. Did you deliberately decide to create something together in one of these areas?
19. Does this project seem to add or detract from the bond between you?
20. If your relationship were a drama, movie or book, what would it be titled? How would it end?

Thanks to Dr. Ellyn Bader & Dr. Peter Pearson from the Couple’s Institute for this questionnaire.